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NPI 1194744185 · Brooklyn, NY · Clinical Medical Laboratory
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Quality Healthcare Management Inc is a clinical medical laboratory provider located in Brooklyn, New York. This profile covers 239 Medicare and 280 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Quality Healthcare Management Inc |
| Address | 2651 E 14th St |
| City | Brooklyn |
| State | NY |
| ZIP | 11235 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | July 19, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $22.3M |
| Medicare | $4.8M |
QUALITY HEALTHCARE MANAGEMENT INC is organized as a Clinical Medical Laboratory and its paid claims mix points to a high-throughput diagnostics operation that combines routine chemistry/hematology, large-scale toxicology, and molecular infectious-disease testing. Medicare activity is heavy in common panels and monitoring tests such as 82306, 84443, 80061 and 80053, while both Medicare and Medicaid volumes include large definitive toxicology codes (G0483, G0482/G0481) and high-volume molecular COVID testing (U0004, 87635). The presence of P9604 at scale on the Medicare side also indicates an operational capability for specimen collection outside the clinic (home or nursing-home draws).
Medicaid ($22.3M) is the dominant payer for this provider compared with Medicare ($4.8M), making Medicaid the primary revenue source in scale. This payer mix suggests the laboratory’s client base and commercial relationships are concentrated toward Medicaid-covered populations or contracts that drive the larger Medicaid billing totals.
Revenue concentration is meaningful on both payers: the top three Medicare codes by revenue account for 28.4% of this provider's total Medicare revenue, with leading Medicare codes including G0483, 82306, and 84443. On the Medicaid side the top three codes account for 38.4% of total Medicaid revenue, with Medicaid top codes including G0483, U0004, and 80307, indicating a narrower set of services that drive a large share of Medicaid receipts.
National competitive standing for routine Medicare lab tests is strong: several common panel and monitoring codes (for example, 82306 ranks #65 of 12453 providers nationally at the 99th percentile and 83036 ranks in the 100th percentile) show notably above-typical or top-tier national volumes, signaling substantial throughput in basic clinical testing. By contrast, Medicare-level definitive toxicology testing such as G0483 sits at rank #60 of 1063 providers (94th percentile) — a healthy national presence but not a singular market leader for that specific code.
In-state competitive standing on Medicaid is concentrated and, in many drug-test categories, dominant. Multiple single-drug and presumptive toxicology codes (for example, 80364, 80348, 80323, 80356, 80353, 80365, 80359, 80349, 80358, 80324, 80361) are marked as rank #1 in-state at the 100th percentile and labeled as "extreme outlier, far above typical state volume for this code," which indicates the provider is a major statewide hub for opioid and single-substance drug testing volumes.
Specific Medicaid toxicology lines are major revenue drivers: G0483 produced 25.4K claims and $2M revenue (15.2% of the provider's total Medicaid revenue) and 80307 generated 115.9K claims and $1.2M revenue (8.9% of Medicaid revenue), both ranking in high state percentiles. These figures, together with many 803xx codes listed as extreme outliers, show that a concentrated toxicology service line is materially responsible for Medicaid revenue.
The provider maintains an active molecular infectious-disease testing footprint across payers: Medicaid U0004 reports 39.3K claims and $1.8M revenue (14.2% of Medicaid revenue) and Medicare data show U0004 at 881 claims and $65.2K revenue; 87635 on Medicare also shows 1.1K claims and $56K revenue and ranks at high national percentiles. This pattern demonstrates ongoing high-throughput SARS–CoV–2 testing capacity and a meaningful role in pandemic-era molecular diagnostics for both payer populations.
QUALITY HEALTHCARE MANAGEMENT INC has a long-established Medicare enrollment (NPI enumerated 2006-07-19 (~20 years ago)) and lifetime reported revenues of $4.8M (Medicare) and $22.3M (Medicaid). Together these facts portray an established, mid- to large-scale laboratory operation with a particularly strong Medicaid-facing business and specialized dominance in state-level toxicology testing.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
239 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 1,750 | $240 | $423.3K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 11,840 | $30 | $343.4K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 16,450 | $20 | $263.2K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 17,720 | $10 | $230.3K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 21,320 | $10 | $213.2K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 13,240 | $20 | $198.6K |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge | 9,150 | $20 | $192.1K |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 1,290 | $140 | $180.6K |
| 82746 | The lab analyst measures the folic acid level in serum to determine if there is a deficiency. Folic acid deficiency is attributed to many conditions such as malabsorption, Crohn’s disease, celiac… | 12,150 | $10 | $170.1K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 16,570 | $10 | $165.7K |
Showing 1–10 of 239
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 239 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
239 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| P9604 | 3 | 10 | 1,880 | $20 | $306.6K |
| 87798 | 15 | 40 | 740 | $30 | $218.3K |
| U0004 | 4 | 20 | 450 | $70 | $114.7K |
| G0483 | 1 | 20 | 270 | $240 | $82.4K |
| G0480 | 27 | 30 | 170 | $110 | $76.5K |
| 87581 | 3 | 10 | 350 | $30 | $64.6K |
| 87486 | 3 | 10 | 350 | $30 | $64.2K |
| G0482 | 5 | 30 | 90 | $190 | $61.8K |
| G0481 | 3 | 30 | 150 | $150 | $50.1K |
| 86235 | 21 | 40 | 650 | $20 | $33.6K |
Showing 1–10 of 239
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
280 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 25,350 | $80 | $2M |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 39,280 | $50 | $1.8M |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 115,950 | $10 | $1.2M |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 52,650 | $20 | $789.7K |
| 80364 | The lab analyst measures the amount of or detects the presence of five or more opioids and opiate analogs, narcotic analgesics that depress the central nervous system, in the specimen. | 97,960 | $10 | $489.8K |
| 80348 | The lab analyst measures the amount of or detects the presence of buprenorphine in a patient specimen. Buprenorphine is a drug used to treat opioid addiction, to control acute pain in individuals who… | 96,770 | $10 | $483.9K |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 4,070 | $100 | $419.5K |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,… | 26,400 | $20 | $396.1K |
| 86481 | The lab analyst performs a test to evaluate an antigen response to certain tuberculosis (TB) antibodies by enumerating T cells that produce gamma interferon. | 14,050 | $30 | $393.4K |
| 80323 | The lab analyst identifies and evaluates the level of alkaloid drugs in a patient specimen that are not specified elsewhere in CPT® by a different code from the class of alkaloids. | 96,240 | $1 | $384.9K |
Showing 1–10 of 280
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
280 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 13 | 100 | 1,490 | $70 | $1.3M |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 20 | 40 | 440 | $90 | $511.9K |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 39 | 140 | 360 | $130 | $492.1K |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,… | 34 | 300 | 1,710 | $20 | $458.6K |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 8 | 110 | 690 | $50 | $442K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 7 | 290 | 1,900 | $30 | $390.6K |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 2 | 30 | 550 | $100 | $359.8K |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 4 | 20 | 240 | $70 | $302K |
| 86481 | The lab analyst performs a test to evaluate an antigen response to certain tuberculosis (TB) antibodies by enumerating T cells that produce gamma interferon. | 4 | 30 | 1,350 | $40 | $300.8K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 30 | 590 | 1,160 | $20 | $277.2K |
Showing 1–10 of 280
Other providers in the same ZIP code as Quality Healthcare Management Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Home Family Care, Inc | NY | Home Health Agency | $0 | $841M |
| S & A Unified Home Care, Inc. | NY | Home Health Agency | $0 | $766.2M |
| All American Homecare Agency Inc. | NY | Home Health Agency | $0 | $758.7M |
| Attentive Home Care Agency Inc | NY | Home Health Agency | $0 | $537.9M |
| Advantage Management Associates Inc. | NY | Home Health Agency | $0 | $335.9M |
| Parkshore Home Health Care LLC | NY | Home Health Agency | $0 | $300.4M |
| Good Care Agency Inc | NY | Home Health Agency | $0 | $264.5M |
| Eagle Eye Fv, Inc | NY | Home Health Agency | $0 | $245M |
| Friendly Home Care | NY | Home Health Agency | $0 | $197.1M |
| All American Homecare Agency Inc. | NY | Home Health Agency | $0 | $166M |
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